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Weight Management Referral


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Invitation and a brief summary  
Congratulations on taking the first step on your Slimming World journey as part of the Wyre weight management scheme. In order to proceed with your application, please complete the following questionnaire.  
We are required to collect some demographic, health, and lifestyle information on behalf of Public Health, Lancashire County Council and Public Health England. who fund the programme. This is to make sure we're reaching everyone in the local community. If there are any questions you don't feel comfortable answering, please select the "Prefer not to say" option. 
What is the purpose of the data collection?  
When you join Slimming World on a scheme funded by Public Health, Lancashire County Council, (LCC) and Public Health England. We have obligations to share the information we collect about you both with Slimming World, LCC and Public Health England.

Who is conducting the data collection?  
The data in the questionnaire is collected by Wyre Council as a part of the initial joining process for members joining through the referral scheme. Within this data collection, only Wyre Council and Slimming World will have access to your data, and the data will be stored securely. For more information, you can contact Wyre Council’s Active Lives & Community Engagement team at or the Slimming World Partnerships Team at
Can I withdraw from participating in the Wyre weight management scheme?  
You have the right to withdraw from the 12-week Slimming World scheme at any time during this initial joining process.  Any personal data you have provided will be encrypted and stored by Slimming World, Wyre Council and LCC/Public Health England. It will be looked at only by personnel linked with the Slimming World  funded programme in Wyre funded by LCC and Public Health England. If you wish to withdraw, please send an email including your unique identifier code (provided to you when you start the questionnaire) to the Wyre Council Active Lives & Community Engagement team at or the Slimming World Partnerships Team at
How will my data be dealt with, and who will see the results?  
Wyre Council collects this data through a system called Jadu Central. The data is compiled using Jadu Connect and then encrypted and securely sent to Slimming World, who use a system called Qualtrics to store the information in this questionnaire. Qualtrics stores data in the UK and will only process your data to the extent necessary to provide Slimming World with the information requested as part of their services.  Any personal data you have provided will be encrypted and stored by Slimming World, and only shared with Wyre Council, LCC, Jadu and Public Health England. The data will not be passed on to third parties.  If you'd like to read the security information regarding this, you can find it on the Slimming World website and the Information Sharing Agreement on our website.
If you'd like to read our Privacy Policy you can view this on our website, and if you have any questions, you can contact our Data Protection Officer at

What if I have a complaint or any concerns?  
Any person with concerns or complaints can view our complaints procedure on our website and submit a complaint via the online form. Alternatively a complaint can be made by email, in writing or by telephone.

I agree to participate in data collection for behavioural weight management services as part of my referral.

  • I have read and understood the information above.
  • I understand I have the right to withdraw from the service at any time.
  • I understand that collected data will be used as part of the behavioural weight management services triage process and outcome analysis by Slimming World NHS Partnership, the relevant Local Authority and Public Health England.
  • I am 16 years of age or over
Please indicate that you agree to the Terms and Conditions Required
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